Opinion5/11/2012

Physician Assisted Suicide offers only the illusion of freedom -- Part II

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Massachusetts voters are expected to vote next November on a ballot initiative that, if approved, will legalize physician-assisted suicide in the Commonwealth.

To assist Catholics in educating themselves on this issue, The Pilot is re-printing the June 2011 statement on physician-assisted suicide issued by the United States Conference of Catholic Bishops, "To live each day with dignity."

This document is being reprinted in four installments during the month of May, in conjunction with the archdiocesan education campaign against doctor-prescribed suicide.

Does the drive to legalize physician-assisted suicide really enhance choices or freedom for people with serious health conditions? No, it does not, for several reasons.

First, medical professionals recognize that people who take their own lives commonly suffer from a mental illness, such as clinical depression. Suicidal desires may be triggered by very real setbacks and serious disappointments in life. However, suicidal persons become increasingly incapable of appreciating options for dealing with these problems, suffering from a kind of tunnel vision that sees relief only in death. They need help to be freed from their suicidal thoughts through counseling and support and, when necessary and helpful, medication. Because the illnesses that cause or aggravate suicidal desires are often overlooked or misdiagnosed, many civil laws provide for psychological evaluation and treatment for those who have attempted suicide. The Catholic Church, as well, recognizes that "grave psychological disturbances, anguish, or grave fear of hardship, suffering, or torture" can diminish the responsibility of people committing suicide; the Church encourages Catholics to pray for them, trusting in God's mercy (CCC, no. 2282-3).

These statements about psychological disturbance and diminished responsibility are also true of people who attempt suicide during serious illness. Yet this is often ignored in proposals authorizing assistance in these individuals' suicides. Many such proposals permit--but do not require--an evaluation for mental illness or depression before lethal drugs are prescribed. In practice such evaluations are rare, and even a finding of mental illness or depression does not necessarily prevent prescribing the drugs. No evaluation is done at the time the drugs are actually taken.

In fact, such laws have generally taken great care to avoid real scrutiny of the process for doctor-prescribed death--or any inquiry into whose choice is served. In Oregon and Washington, for example, all reporting is done solely by the physician who prescribes lethal drugs. Once they are prescribed, the law requires no assessment of whether patients are acting freely, whether they are influenced by those who have financial or other motives for ensuring their death, or even whether others actually administer the drugs. Here the line between assisted suicide and homicide becomes blurred.

People who request death are vulnerable. They need care and protection. To offer them lethal drugs is a victory not for freedom but for the worst form of neglect. Such abandonment is especially irresponsible when society is increasingly aware of elder abuse and other forms of mistreatment and exploitation of vulnerable persons.

Second, even apparently free choices may be unduly influenced by the biases and wishes of others. Legalization proposals generally leave in place the laws against assisting most people to commit suicide, but they define a class of people whose suicides may be facilitated rather than prevented. That class typically includes people expected to live less than six months. Such predictions of a short life are notoriously unreliable. They also carry a built-in ambiguity, as some legal definitions of terminal illness include individuals who have a short time to live only if they do not receive life-supporting treatment. Thus many people with chronic illnesses or disabilities--who could live a long time if they receive basic care--may be swept up in such a definition. However wide or narrow the category may be, it defines a group of people whose death by lethal overdose is wrongly treated by the law as objectively good or acceptable, unlike the suicide of anyone else.

By rescinding legal protection for the lives of one group of people, the government implicitly communicates the message--before anyone signs a form to accept this alleged benefit--that they may be better off dead. Thus the bias of too many able-bodied people against the value of life for someone with an illness or disability is embodied in official policy.

This biased judgment is fueled by the excessively high premium our culture places on productivity and autonomy, which tends to discount the lives of those who have a disability or are dependent on others. If these persons say they want to die, others may be tempted to regard this not as a call for help but as the reasonable response to what they agree is a meaningless life. Those who choose to live may then be seen as selfish or irrational, as a needless burden on others, and even be encouraged to view themselves that way.

In short, the assisted suicide agenda promotes a narrow and distorted notion of freedom, by creating an expectation that certain people, unlike others, will be served by being helped to choose death. Many people with illnesses and disabilities who struggle against great odds for their genuine rights--the right to adequate health care and housing, opportunities for work and mobility, and so on--are deservedly suspicious when the freedom society most eagerly offers them is the "freedom" to take their lives.

Third, there is a more profound reason why the campaign for assisted suicide is a threat, not an aid, to authentic human freedom.

The founders of our country declared that each human being has certain inalienable rights that government must protect. It is no accident that they named life before liberty and the pursuit of happiness. Life itself is a basic human good, the condition for enjoying all other goods on this earth. Therefore the right to life is the most basic human right. Other valued rights--the right to vote, to freedom of speech, or to equal protection under law--lose their foundation if life itself can be destroyed with impunity.

As Christians we go even further: Life is our first gift from an infinitely loving Creator. It is the most fundamental element of our God-given human dignity. Moreover, by assuming and sharing our human nature, the Son of God has more fully revealed and enhanced the sacred character of each human life.

Therefore one cannot uphold human freedom and dignity by devaluing human life. A choice to take one's life is a supreme contradiction of freedom, a choice to eliminate all choices. And a society that devalues some people's lives, by hastening and facilitating their deaths, will ultimately lose respect for their other rights and freedoms.

Thus in countries that have used the idea of personal autonomy to justify voluntary assisted suicide and euthanasia, physicians have moved on to take the lives of adults who never asked to die, and newborn children who have no choice in the matter. They have developed their own concept of a "life not worth living" that has little to do with the choice of the patient. Leaders of the "aid in dying" movement in our country have also voiced support for ending the lives of people who never asked for death, whose lives they see as meaningless or as a costly burden on the community.